National Center for Global Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1 00133, Rome, Italy.
Med Microbiol Immunol. 2018 Aug;207(3-4):175-182. doi: 10.1007/s00430-018-0537-2. Epub 2018 Feb 27.
Transplacental passage of IgGs is impaired in HIV + pregnant women, possibly determining an inadequate immunological protection in their children. We aimed to determine the impact of maternal immunological IgG profile and immunoactivation status on the efficiency of transplacental passage of IgG subclasses in HIV + mothers.
16 mother/infants pairs were studied in Malawi. Mothers received antiretroviral therapy (ART) from the third trimester of pregnancy. Determinations of pre-ART levels of maternal sCD14, of IgG subclasses in mothers at delivery and in their 1-month-old infants, were performed using commercial ELISA kits.
At delivery, after a median of 10 weeks of ART, 12/16 mothers were hypergammaglobulinemic, with IgG levels (20.5 mg/ml, 95% CI:18.8-26.8) directly correlated to the plasmatic levels of sCD14 (r = 0.640, p = 0.014). IgG1 levels (17.9 mg/ml) accounted for 82% of IgG, IgG3 and IgG4 levels were in the normal range. A profound deficit of IgG2 was observed both in mothers (0.60 mg/ml) and in infants (0.14 mg/ml). Placental transfer ratio (range 0.16-0.42) did not show a selective impairment between the different IgG subclasses. The transplacental passage of all IgG subclasses was decreased in the presence of maternal IgG over 16 mg/ml (significantly for IgG1, p = 0.031) and of high levels of sCD14 (p = 0.063).
Transplacental passage was reduced for all IgG subclasses and inversely correlated to high levels of maternal IgGs and to the degree of immunoactivation. The profound depression of IgG2 in mothers suggests that IgG2 neonatal levels mostly reflect the maternal deficit rather than a selective impairment of IgG2 transfer.
HIV 阳性孕妇的 IgG 经胎盘转运受损，可能导致其婴儿的免疫保护不足。本研究旨在确定母体免疫 IgG 谱和免疫激活状态对 HIV 阳性孕妇 IgG 亚类经胎盘转运效率的影响。
在马拉维研究了 16 对母婴。母亲在妊娠晚期接受抗逆转录病毒治疗（ART）。使用商业 ELISA 试剂盒测定母亲在 ART 前、分娩时和 1 月龄婴儿的 IgG 亚类的 sCD14 水平。
在分娩时，经过中位数为 10 周的 ART 后，16 例母亲中的 12 例出现高丙种球蛋白血症，IgG 水平（20.5mg/ml，95%CI：18.8-26.8）与 sCD14 的血浆水平直接相关（r=0.640，p=0.014）。IgG1 水平（17.9mg/ml）占 IgG 的 82%，IgG3 和 IgG4 水平处于正常范围。母亲和婴儿的 IgG2 均显著缺乏（0.60mg/ml 和 0.14mg/ml）。胎盘转运比（范围 0.16-0.42）在不同 IgG 亚类之间没有表现出选择性缺陷。在母体 IgG 超过 16mg/ml（IgG1 显著，p=0.031）和 sCD14 高水平（p=0.063）的情况下，所有 IgG 亚类的经胎盘转运均减少。
所有 IgG 亚类的经胎盘转运均减少，与母体 IgG 水平升高和免疫激活程度呈负相关。母亲 IgG2 的严重缺乏表明，新生儿 IgG2 水平主要反映了母体的缺乏，而不是 IgG2 转移的选择性缺陷。
